Useless Recertification: it’s not just for doctors any more.


The process I do to maintain

Certification is too hard to explain

The Board, corrupted by powers,

Just wastes my hours

And puts dollars right down the drain.

Synopsis: I’m a Family Practitioner from Sioux City, Iowa. In 2010 I danced back from the brink of burnout, and honoring a 1 year non-compete clause, traveled and worked in out-of-the-way places in Alaska, Nebraska, Iowa, and New Zealand. After three years working with a Community Health Center, I went back to adventures in temporary positions until they have an Electronic Medical Record (EMR) system I can get along with. Assignments in Nome, Alaska, rural Iowa, and suburban Pennsylvania stretched into fall 2015. Since last winter I’ve worked in Alaska and western Nebraska, and taken time to deal with my wife’s (benign) brain tumor. After a moose hunt in Canada, and a couple of assignments in western Iowa, I’m back in Alaska. Any identifiable patient information has been included with permission.

The physician community at large carries a grudge against Maintenance of Certification (MOC).

I suppose I agree with the general concept: that truth has a finite half-life, and that skills not continually updated deteriorate. Thus, during my radio career in 60s and 70s, my Third Class Radiotelephone Operator’s License from the FCC never needed updating, and, to the best of my knowledge, is still good.  Because I’ve not done broadcasting for almost 50 years, and because the nature of the job must have changed, it probably would do no good.

I knew a doc in Sioux City who got his Internal Medicine Board certification the last year it represented a lifetime ticket; after that all the internists had to take an exam every 10 years. He retired the same year I first went walkabout.

Family Practice, from its inception, embraced the concept of keeping current with an exam every 7 years.

The real world involves mission creep.  The American Board of Family Medicine (ABFM) has made the recertification process increasingly Byzantine.  A rep from that Board, at a Continuing Medical Education lecture said, in so many words, If it takes you more than 5 minutes to figure out what you need to do, call the Board.  There are well-trained people standing by to help you.

Too polite to express outrage, none of us said, “If your process has to be explained to people who take tests for a living, it’s too complicated.”

Eventually, when things got bad enough, the doctors rebelled. The American Board of Internal Medicine made the MOC process so complex, time-consuming, and expensive that a group of physicians broke away, formed their own Board, and went into competition.  The ABIM immediately apologized to its members, and backed off the requirements.  For a lot of docs who had hit an emotional tipping point, it was too little, too late.

The ABFM simplified things two years ago, but not enough to allow description in less than 500 words.

I talked to a patient involved in electric power generation (he gave me permission to write more than I have). At one time he held 8 professional certificates, but his work morphed so he let some tickets lapse one by one.  And none of them came cheap.

Bethany, a professional educator by training, is using her time here to complete her Maintenance of Certification. Which boils down to a lot of busy work, a needless expense, poorly worded tests with marginal validation, and has never demonstrated a benefit for anyone except those who charge her for the privilege.

But you could say the same thing of the recertification process for Family Practice.

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